Provider Demographics
NPI:1699122374
Name:HERNANDEZ, ALEXANDER (BCABA)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:HERNANDEZ
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15455 SW 75TH CIRCLE LN
Mailing Address - Street 2:APT 213
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3366
Mailing Address - Country:US
Mailing Address - Phone:786-474-2130
Mailing Address - Fax:
Practice Address - Street 1:14671 SW 114TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-7038
Practice Address - Country:US
Practice Address - Phone:786-474-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2018-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty